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American Journal of Alzheimer's Disease and Other Dementias®
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Geographical Differences in the Occurrence of Alzheimer's Disease Mortality: United States Versus Puerto Rico

Raul Figueroa, MS

Center for the Interdisciplinary Study of Genes, Brain and Mind, FILIUS Institute, University of Puerto Rico, San Juan, Puerto Rico

Kyle Steenland, PhD

Alzheimer's Disease Research Center, EMORY University School of Medicine, Atlanta, Georgia, Department of Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, Georgia

Jessica R. MacNeil, MS

Department of Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, Georgia

Allan I. Levey, MD, PhD

Alzheimer's Disease Research Center, EMORY University School of Medicine, Atlanta, Georgia

Irving E. Vega, PhD

Center for the Interdisciplinary Study of Genes, Brain and Mind, FILIUS Institute, University of Puerto Rico, San Juan, Puerto Rico, ievega{at}vmail.uprrp.edu, Department of Biology, University of Puerto Rico-Rio Piedras Campus, San Juan, Puerto Rico

Since the implementation of the 10th International Classification of Disease in 1999, the trend in Alzheimer's disease mortality rate has not been reported. Here, the age-adjusted Alzheimer's disease mortality rate in Puerto Rico and United States from 1999 to 2004 was analyzed. The results showed an increasing trend in Alzheimer's disease mortality rate in both the United States and Puerto Rico. However in Puerto Rico, the Alzheimer's disease mortality rate (32.4/100 000) was higher than that observed in United States (20.9/100 000). Interestingly, the Alzheimer's disease mortality rate of Puerto Ricans living in Puerto Rico is much higher than Puerto Ricans living in the United States. The higher occurrence of Alzheimer's disease mortality in Puerto Rico versus the United States could be explained by factors such as coding practices, genetics, socioeconomics, and health care. These results highlight the need for comprehensive studies on factors that may influence diagnosis, death certificate coding practices, and development of Alzheimer's disease pathology in different geographical regions.

Key Words: Alzheimer's disease • tauopathy • Hispanics • epidemiology • mortality rate

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 23, No. 5, 462-469 (2008)
DOI: 10.1177/1533317508321909
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